Education and adolescent cognitive ability as predictors of dementia in a cohort of Danish men

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Education and adolescent cognitive ability as predictors of dementia in a cohort of Danish men. / Foverskov, Else; Glymour, M. Maria; Mortensen, Erik Lykke; Osler, Merete; Okholm, Gunhild Tidemann; Lund, Rikke.

In: PLoS ONE, Vol. 15, No. 8, 0235781, 2021.

Research output: Contribution to journalJournal articlepeer-review

Harvard

Foverskov, E, Glymour, MM, Mortensen, EL, Osler, M, Okholm, GT & Lund, R 2021, 'Education and adolescent cognitive ability as predictors of dementia in a cohort of Danish men', PLoS ONE, vol. 15, no. 8, 0235781. https://doi.org/10.1371/journal.pone.0235781

APA

Foverskov, E., Glymour, M. M., Mortensen, E. L., Osler, M., Okholm, G. T., & Lund, R. (2021). Education and adolescent cognitive ability as predictors of dementia in a cohort of Danish men. PLoS ONE, 15(8), [0235781]. https://doi.org/10.1371/journal.pone.0235781

Vancouver

Foverskov E, Glymour MM, Mortensen EL, Osler M, Okholm GT, Lund R. Education and adolescent cognitive ability as predictors of dementia in a cohort of Danish men. PLoS ONE. 2021;15(8). 0235781. https://doi.org/10.1371/journal.pone.0235781

Author

Foverskov, Else ; Glymour, M. Maria ; Mortensen, Erik Lykke ; Osler, Merete ; Okholm, Gunhild Tidemann ; Lund, Rikke. / Education and adolescent cognitive ability as predictors of dementia in a cohort of Danish men. In: PLoS ONE. 2021 ; Vol. 15, No. 8.

Bibtex

@article{102ecbf1454a4e0b9c93c8bc4e60c468,
title = "Education and adolescent cognitive ability as predictors of dementia in a cohort of Danish men",
abstract = "Background An association between education and dementia is well-established but it is unclear whether education is associated with dementia after accounting for early life cognitive ability and whether there is a joint effect, such that the risk associated with one of the exposures depends on the value of the other. We examined separate and joint associations of adolescent cognitive ability and educational attainment with risk of dementia among Danish men born between 1939 and 1959. Methods Men (N = 477,421) from the Danish Conscription Database were followed for dementia from the age 60 for up to 17 years via patient and prescription registry linkages. Exposure measures included cognitive ability assessed at the conscript board examination around age 18 and highest educational level (low: 0-10 year, medium: 10-13 years, high: >= 13 years) at age 30 from registry records. Associations with dementia diagnosis were estimated in Cox proportional hazards models adjusted for birth year and age at conscript board examination. Interaction was assessed on the multiplicative scale by including a product term between the two exposure measures and on the additive scale by calculating relative excess risk due to interaction (RERI) between different levels of the exposure measures. Results Compared to men in the high education group hazard ratio [HR] for men in the medium and low group were 1.21 (95% confidence interval [CI]: 1.13, 1.30) and 1.34 (95% CI: 1.24, 1.45), respectively when not adjusting for cognitive ability. Additional adjustment for cognitive ability attenuated the magnitude of the associations, but they remained significant (education medium: HR = 1.10, 95% CI: 1.02, 1.19 and education low: HR = 1.12, 95% CI: 1.02, 1.22). A 10% higher cognitive ability score was associated with a 3.8% lower hazard of dementia (HR = 0.962; 95% CI: 0.957, 0.967), and the magnitude of the association only changed marginally after adjustment for education. Men in the low education group with relatively low cognitive ability were identified as a high-risk subgroup for dementia. The increased risk associated with exposure to both risk factors did, however, not significantly depart from the sum of risk experienced by men only exposed to one of the risk factors (estimates of RERI were not significantly different from 0) and no significant evidence of either additive or multiplicative interactions was found. Conclusions In conclusion, the results suggest that education and cognitive ability protect against the risk of dementia independently of one another and that increases in educational attainment may at least partially offset dementia risk due to low cognitive ability.",
keywords = "LIFE-COURSE, INTELLIGENCE, CHILDHOOD, HEALTH, RISK",
author = "Else Foverskov and Glymour, {M. Maria} and Mortensen, {Erik Lykke} and Merete Osler and Okholm, {Gunhild Tidemann} and Rikke Lund",
year = "2021",
doi = "10.1371/journal.pone.0235781",
language = "English",
volume = "15",
journal = "PLoS ONE",
issn = "1932-6203",
publisher = "Public Library of Science",
number = "8",

}

RIS

TY - JOUR

T1 - Education and adolescent cognitive ability as predictors of dementia in a cohort of Danish men

AU - Foverskov, Else

AU - Glymour, M. Maria

AU - Mortensen, Erik Lykke

AU - Osler, Merete

AU - Okholm, Gunhild Tidemann

AU - Lund, Rikke

PY - 2021

Y1 - 2021

N2 - Background An association between education and dementia is well-established but it is unclear whether education is associated with dementia after accounting for early life cognitive ability and whether there is a joint effect, such that the risk associated with one of the exposures depends on the value of the other. We examined separate and joint associations of adolescent cognitive ability and educational attainment with risk of dementia among Danish men born between 1939 and 1959. Methods Men (N = 477,421) from the Danish Conscription Database were followed for dementia from the age 60 for up to 17 years via patient and prescription registry linkages. Exposure measures included cognitive ability assessed at the conscript board examination around age 18 and highest educational level (low: 0-10 year, medium: 10-13 years, high: >= 13 years) at age 30 from registry records. Associations with dementia diagnosis were estimated in Cox proportional hazards models adjusted for birth year and age at conscript board examination. Interaction was assessed on the multiplicative scale by including a product term between the two exposure measures and on the additive scale by calculating relative excess risk due to interaction (RERI) between different levels of the exposure measures. Results Compared to men in the high education group hazard ratio [HR] for men in the medium and low group were 1.21 (95% confidence interval [CI]: 1.13, 1.30) and 1.34 (95% CI: 1.24, 1.45), respectively when not adjusting for cognitive ability. Additional adjustment for cognitive ability attenuated the magnitude of the associations, but they remained significant (education medium: HR = 1.10, 95% CI: 1.02, 1.19 and education low: HR = 1.12, 95% CI: 1.02, 1.22). A 10% higher cognitive ability score was associated with a 3.8% lower hazard of dementia (HR = 0.962; 95% CI: 0.957, 0.967), and the magnitude of the association only changed marginally after adjustment for education. Men in the low education group with relatively low cognitive ability were identified as a high-risk subgroup for dementia. The increased risk associated with exposure to both risk factors did, however, not significantly depart from the sum of risk experienced by men only exposed to one of the risk factors (estimates of RERI were not significantly different from 0) and no significant evidence of either additive or multiplicative interactions was found. Conclusions In conclusion, the results suggest that education and cognitive ability protect against the risk of dementia independently of one another and that increases in educational attainment may at least partially offset dementia risk due to low cognitive ability.

AB - Background An association between education and dementia is well-established but it is unclear whether education is associated with dementia after accounting for early life cognitive ability and whether there is a joint effect, such that the risk associated with one of the exposures depends on the value of the other. We examined separate and joint associations of adolescent cognitive ability and educational attainment with risk of dementia among Danish men born between 1939 and 1959. Methods Men (N = 477,421) from the Danish Conscription Database were followed for dementia from the age 60 for up to 17 years via patient and prescription registry linkages. Exposure measures included cognitive ability assessed at the conscript board examination around age 18 and highest educational level (low: 0-10 year, medium: 10-13 years, high: >= 13 years) at age 30 from registry records. Associations with dementia diagnosis were estimated in Cox proportional hazards models adjusted for birth year and age at conscript board examination. Interaction was assessed on the multiplicative scale by including a product term between the two exposure measures and on the additive scale by calculating relative excess risk due to interaction (RERI) between different levels of the exposure measures. Results Compared to men in the high education group hazard ratio [HR] for men in the medium and low group were 1.21 (95% confidence interval [CI]: 1.13, 1.30) and 1.34 (95% CI: 1.24, 1.45), respectively when not adjusting for cognitive ability. Additional adjustment for cognitive ability attenuated the magnitude of the associations, but they remained significant (education medium: HR = 1.10, 95% CI: 1.02, 1.19 and education low: HR = 1.12, 95% CI: 1.02, 1.22). A 10% higher cognitive ability score was associated with a 3.8% lower hazard of dementia (HR = 0.962; 95% CI: 0.957, 0.967), and the magnitude of the association only changed marginally after adjustment for education. Men in the low education group with relatively low cognitive ability were identified as a high-risk subgroup for dementia. The increased risk associated with exposure to both risk factors did, however, not significantly depart from the sum of risk experienced by men only exposed to one of the risk factors (estimates of RERI were not significantly different from 0) and no significant evidence of either additive or multiplicative interactions was found. Conclusions In conclusion, the results suggest that education and cognitive ability protect against the risk of dementia independently of one another and that increases in educational attainment may at least partially offset dementia risk due to low cognitive ability.

KW - LIFE-COURSE

KW - INTELLIGENCE

KW - CHILDHOOD

KW - HEALTH

KW - RISK

U2 - 10.1371/journal.pone.0235781

DO - 10.1371/journal.pone.0235781

M3 - Journal article

C2 - 32760096

VL - 15

JO - PLoS ONE

JF - PLoS ONE

SN - 1932-6203

IS - 8

M1 - 0235781

ER -

ID: 247981492